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  • 1
    Digitale Medien
    Digitale Medien
    Springer
    Pediatric nephrology 8 (1994), S. 667-670 
    ISSN: 1432-198X
    Schlagwort(e): Nephrotic syndrome ; Steroid therapy ; Cyclophosphamide ; Bone mineral density ; Peripheral quantitative computed tomography
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract Bone mineral density (BMD) was studied in 26 children with idiopathic nephrotic syndrome and in age-and sex-matched healthy controls. BMD was selectively measured in trabecular (TBD), cortical (CBD) and total bone (BD) using peripheral quantitative computed tomography. Patients showed a decrease in BD, CBD and TBD, BD and CBD were inversely correlated with the cumulative dose of steroid treatment. Of the 26 patients with high cumulative doses of steroid, 16 were also treated with cyclophosphamide. In this group BD and CBD were decreased significantly compared with the children with a low cumulative steroid dose only. Compared with controls for each subgroup, significant decreases in BD, CBD and TBD were found in the group with high cumulative doses of steroids only. The higher cumulative steroid dose and the initial steroid toxicity which made cytotoxic therapy necessary, rather than cyclophosphamide itself, may be responsible for these findings.
    Materialart: Digitale Medien
    Bibliothek Standort Signatur Band/Heft/Jahr Verfügbarkeit
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  • 2
    Digitale Medien
    Digitale Medien
    Springer
    Pediatric nephrology 9 (1995), S. 435-437 
    ISSN: 1432-198X
    Schlagwort(e): Haematuria ; Phase contrast microscopy ; Dysmorphic erythrocytes ; G1-cells
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract Urine samples from 100 children and adolescents with micro-or macrohaematuria were investigated using phase contrast microscopy to establish the percentage of G1-cells that could differentiate glomerular from non-glomerular haematuria. The G1-cell is a special form of dysmorphic erythrocyte which seems to be specific for glomerular haematuria. Glomerular haematuria, defined by clinical criteria from biopsy, physical examination, standard laboratory evaluation and family history, was observed in 51 patients (group 1). Non-glomerular haematuria was found in 49 patients (group 2). The latter group had urinary tract infections, urolithiasis, hypercalciuria or haematuria caused by urological operation or diagnostic procedure. The percentage of dysmorphic erythrocytes differed significantly between the two groups studied (42±3% in group 1 vs. 6±1% in group 2, mean±SEM,P〈0.01); there was also a significant difference in G1-cells (19.4±1.7% in group 1 vs. 0.6±0.2% in group 2, mean±SEMP〈0.01). When glomerular haematuria was defined on the basis of ≥30% dysmorphic erythrocytes by phase contrast microscopy, sensitivity, specificity and efficiency were 71%, 100% and 85%, respectively. When glomerular haematuria was defined on the basis of ≥5% G1-cells, sensitivity, specificity and efficiency were 100%, 100% and 100%, respectively. The differentiation of glomerular and non-glomerular haematuria in children by determination of G1-cells appears to be more sensitive and efficient than the determination of the percentage of dysmorphic erythrocytes by phase contrast microscopy.
    Materialart: Digitale Medien
    Bibliothek Standort Signatur Band/Heft/Jahr Verfügbarkeit
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  • 3
    ISSN: 1432-198X
    Schlagwort(e): Key words: Calcium acetate   ;   Calcium carbonate   ;   Pediatric hemodialysis   ;   Hypercalcemia   ;   Phosphate binder   ;   Parathyroid hormone   ;   Hyperparathyroidism
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract. Calcium carbonate is widely used as an oral phosphorus binder to control hyperphosphatemia in children on maintenance hemodialysis. Intestinal calcium absorption may induce hypercalcemia, particularly if calcitriol is given simultaneously. In adults, calcium acetate binds phosphorus more effectively than calcium carbonate, while reducing the frequency of hypercalcemic events. We therefore compared calcium acetate with calcium carbonate in nine pediatric patients on long-term maintenance hemodialysis. Following a 1-week withdrawal of phosphorus binders, calcium carbonate was administered for 7 weeks; after a second withdrawal, calcium acetate was given for another 7 weeks. All patients received calcitriol regularly. Both agents lowered the serum phosphorus concentration significantly (calcium carbonate 5.7±1.4 vs. 7.7±2.1 mg/dl, P〈0.005; calcium acetate 5.8±1.4 vs. 7.8±2.0 mg/dl, P〈0.005). Significantly less elementary calcium was ingested with calcium acetate than with calcium carbonate: 750 (375 – 1,500) vs. 1,200 (0 – 3,000) mg calcium/day, P〈0.0001. With calcium carbonate serum calcium increased significantly. The number of episodes of hyperphosphatemia or hypercalcemia did not differ between treatments. Intact plasma parathyroid hormone (PTH) decreased significantly with both phosphate binders, and serum 25-hydroxyvitamin D3 increased. There was a close relationship between serum phosphorus and PTH in prepubertal but not in pubertal patients. We conclude that hyperphosphatemia can be controlled effectively by both calcium acetate and calcium carbonate in pediatric hemodialysis patients. The oral load of elementary calcium is reduced significantly by binding phosphorus with calcium acetate instead of calcium carbonate; nevertheless, hypercalcemic episodes remain equally frequent with both phosphate binders.
    Materialart: Digitale Medien
    Bibliothek Standort Signatur Band/Heft/Jahr Verfügbarkeit
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